High dose vitamin D therapy for chronic pain in children and adolescents with sickle cell disease: results of a randomized double blind pilot study

Abstract

We report results of a pilot study of high-dose vitamin D in sickle cell disease (SCD). Subjects were given a 6-week course of oral high-dose cholecalciferol (4000-100 000 IU per week) or placebo and monitored prospectively for a period of six months. Vitamin D insufficiency and deficiency was present at baseline in 82·5% and 52·5% of subjects, respectively. Subjects who received high-dose vitamin D achieved higher serum 25-hydroxyvitamin D, experienced fewer pain days per week, and had higher physical activity quality-of-life scores. These findings suggest a potential benefit of vitamin D in reducing the number of pain days in SCD. Larger prospective studies with longer duration are needed to confirm these effects.

© 2012 Blackwell Publishing Ltd.

Figures

Figure 1

[a]: The scatter plot depicts the relationship between serum 25OHD concentrations (nmol/l) with the number of pain days for the vitamin D group (dark circles, bold line) and placebo group (open circles, dotted line) at week 8. The slope of the regression lines representing the strength of the relationship between 25OHD and number of pain days varied at each time point in the study. Serum 25OHD concentrations correlated negatively with the number of pain days at week 8 (r = −0.680 95% CI [−0.903, −0.102], p=0.019) for vitamin D group compared to the placebo group (r = −0.403 95% CI [−0.816, −0.324], p=0.258) [b]: There was a distinct trend towards fewer pain days between visits over the first 16 weeks of the study in the vitamin D group. Although this change did not reach statistical significance due to the small sample size, it is in contrast to the sporadic fluctuation in the number of pain days seen in the placebo group over the same time period.

Figure 1

[a]: The scatter plot depicts the relationship between serum 25OHD concentrations (nmol/l) with the number of pain days for the vitamin D group (dark circles, bold line) and placebo group (open circles, dotted line) at week 8. The slope of the regression lines representing the strength of the relationship between 25OHD and number of pain days varied at each time point in the study. Serum 25OHD concentrations correlated negatively with the number of pain days at week 8 (r = −0.680 95% CI [−0.903, −0.102], p=0.019) for vitamin D group compared to the placebo group (r = −0.403 95% CI [−0.816, −0.324], p=0.258) [b]: There was a distinct trend towards fewer pain days between visits over the first 16 weeks of the study in the vitamin D group. Although this change did not reach statistical significance due to the small sample size, it is in contrast to the sporadic fluctuation in the number of pain days seen in the placebo group over the same time period.